My 6 keys to beating anal fissures

After dealing with anal fissures for 7 years, I'm free

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My 6 keys to beating anal fissures

Postby timj85 » 24 Mar 2017, 23:38

Up until recently, I had been dealing with anal fissures for the best part of 7 years. I'd seen everything, from little bits of blood on the toilet paper, to bowel movements that made me think they were the closest I'd come to child birth (I'm male). After feeling like I'd tried everything and resigning myself to the fact that I was headed for my second surgery, I consulted my specialist and did some more internet research. The result - I'm free.

First, a little about me. I'm 31, live in Melbourne, Australia, am fit, sporty, healthy. I eat well (I'm married to a dietitian, am always active and there's never been a reason for me to suffer from AFs. I first started noticing bits of blood on the toilet paper around 7 years ago. I wasn't overly worried. I saw a specialist who said the general rule is if the blood is bright red, it's fresh and there's not much to worry about. If it's dark red, then the blood might be from higher up the passageways and it is worth getting checked out. At the encouragement of my father, I had a colonoscopy and all was fine. Interestingly, these problems started with loser BMs, I can't remember any serious constipation.

Around 3 years ago I'd been working full-time for a few years and things changed. I had a few very constipated BMs and gradually I began to suffer from AFs. It was a gradual process. Sometimes I'd have good movements and no blood, sometimes I'd have terrible movements coupled with blood. Eventually, it became so bad that I dreaded going to the toilet. After movements, I'd try to hurry back to my desk and just sit and not move. It didn't seem right for a healthy person in their late 20s. Reading some of the posts here, I think I was lucky in that I never persistently suffered from spasms. I did have them, and some hurt like hell, but they were only sporadic.

Deciding that I was too young to fear BMs for the rest of my life, I consulted the specialist. He said I had three options:
1. Live with it
2. Fissurectomy and botox - cut out the anal fissure and inject botox to loosen the surrounding muscles
3. Sphincterotomy - make an incision in the sphincter to allow it to stretch through bad BMs. Small risk of permanent incontenance

Number 3 scared the shit out of me (pardon the pun) and I thought number 2 was worth a try, so I had my first surgery. The specialist said "they have a high rate of recurrence, so I'll probably see you again in 5 years." Unsurprisingly, I've always had these words in the back of my mind.

The surgery recovery was painful, and of course, a little embarrassing, but it was worth it. It greatly helped and I almost got back to a blank canvass.

Around 1.5 years after the surgery, I had another three terrible BMs which felt like child birth. Squeezing as hard as I possibly could, it was deja vu I didn't want to see. I was heading down a path I'd already been. I feared BMs and what's worse, when eating, I was always mindful that what I was eating had to come out at some stage. It wasn't good.

I reconsulted my specialist thinking I'd be off to surgery once more. Then the good news started.

My tips for beating AFs:

1. This post was my guiding light: http://www.embarrassingproblems.com/pro ... re-tackled. I have always been fairly regular, so I didn't use the laxatives. I didn't do the contraction exercises. I purchased a sitz bath and after a while, found them quite relaxing and enjoyable.

2. Drink copious amounts of water: I'd always wondered if there was only something that could lubricate my stools. Turns out there is: water. I drank stupid amounts of water. I tried to follow "one glass every waking hour." Funny thing, I'd always thought that I'd drank a lot of water, but this was next level. I was peeing about 6-10 times per day, and my pee was always clear.

3. Drink water with and after food. I found that if I drink in between meals, the water would go straight through me. Drinking water with food, I reasoned, would help keep the food mushy as it went down. This has worked well for me, and my dietitian wife thinks there is merit to it.

4. The big kicker - my specialist prescribed me an ointment. I'd always used rectogesic, but this new stuff didn't have side effects and he'd had good success with it. Now the label has faded, but from what I can decipher, it was "50 Lionocaine 5 Nifedirine." Whatever that means. If anyone really wants to know, I can go back to the chemist and check. (p.s. I'd always used rectogesic by following the instructions and inserting it into the anus - my specialist said this is dumb, he doesn't know why they do say that, but it's best to apply it lightly on the outside).

5. Keep a food diary and run experiments - it can only help. I kept a diary and for a long time, I couldn't see any discernible pattern. It drove me nuts. Eventually, I realised a few trends and discovered a few foods which don't agree with me. I had a few very bad movements after steak (beef) the night before. So I cut it out. I also had suspicions around nuts, corn, ice cream and chocolate. Basically, cut out anything that is hard to digest. I've brought back in some nuts, but even now, if I eat a few handfuls of nuts, I notice the next day. There's definitely a balance. I had suspicions about dairy and wheat, but I've cleared both. Run experiments by cutting things out or eating lots of one thing and observing the responses. Patterns might not present immediately, but hopefully they will over time.

6. Psyllium husk powder - my best friend. Keeps me regular (super important!), enlarges the stool and keeps it soft. Experiment with the number of times per day - for me, once in the evening before dinner has worked well. Make sure it is followed with plenty of water. I also dabbled in prune juice to help regularity.

Those are my six keys to success. I am very confident that it won't work for everyone, but I am equally confident that parts will be very helpful.

Now my plan is to be ever-vigilant. If I have a bad movement, go back to the proven diet. Be strict again. If things are looking good, I'll allow myself some more freedom. But for me one thing was clear - I had the surgery which fixed things, but then they gradually got worse again. Change was needed - something had to give. I'll be drinking psyllium husk powder with water for the rest of my life, maybe not every day, but it has become a staple of my diet.

If you're having trouble, I wish you all the best. Stay positive, stay cool, there is light at the end of the tunnel.

Good luck!
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Re: My 6 keys to beating anal fissures

Postby NikkiB69 » 25 Mar 2017, 03:21

Thank you for all these great tips. Some I'm already doing, will try some of the others. Much like yourself I'm trying to avoid any further surgery!! (sometimes I regret the hem surgery I've already had, I'm sure it caused this fissure!)
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Re: My 6 keys to beating anal fissures

Postby FissureVictim » 19 Apr 2017, 13:14

Hi Timj85, I think the ointment is Nifedipine (Calcium channel blocker) and Lidocaine (Local anesthetic). Thank you for sharig your tips. I do use the same ointment. Used it for 5 weeks and healed 78-80%. Then constipated a lil bit and back to square one. Now continuing to apply the same but also requestingmy doc to give prescription for suppositories of the same. She said that my fissure is mostly internal. Hopefully suppositories helps!! Fingers crossed.
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Re: My 6 keys to beating anal fissures

Postby Buttercup » 19 Apr 2017, 14:29

Thanks for the post. I'm only resently diagnosed and know absolutely nothing apart from what iv learnt from being on this forum fir 1 day only! I never thought of a food diary! I will try and water with meals is grate advise! Where ever do you buy sitz baths from? I brought some coconut oil on advice from this forum today, helps to moistureise the area I hear! I had a baby a year ago and the discomfort is worse. Thanks again for advise and help!
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Re: My 6 keys to beating anal fissures

Postby missy moo » 29 May 2017, 22:13

Timj85 how are you going i too will probably be getting a fissurectomy an botox just woundering how your experience was an how your doing now how manyweeks post surgery? Thanks
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Re: My 6 keys to beating anal fissures

Postby timj85 » 29 May 2017, 23:17

Hey missy moo, I had the surgery about two and a half years ago. I had it at a point where every BM was very painful, with lasting pain after the movement. I was looking at having it again last year as my fissures had returned to a similar point, but my specialist suggested using the cream instead (50 Nifedipine 0.5%, Lignocaine 5% Ointment). It worked very effectively. It took a while, but meant I avoided the surgery. If you haven't tried this, I'd strongly recommend it.

If the surgery is unavoidable, my experience was positive. The healing process was slow, the first BM was extremely painful, sitting down hurt for about a week, but it was definitely worth it. Good luck!
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Re: My 6 keys to beating anal fissures

Postby missy moo » 30 May 2017, 01:09

Thanks for that I think since my fissure has come an gone for 3.5 years there would 've a build up of weak scar? How long had you had your fissure before surgery ? And did it come and go? Did you have a build up if scar tissue?
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Re: My 6 keys to beating anal fissures

Postby timj85 » 30 May 2017, 01:12

Before the surgery, I'd be dealing with fissures for about the same time, maybe a little longer. It came and went until one eventually it just stayed. It obviously got worse and worse closer to the surgery, so yes, there was scar tissue.

I'm not sure about the more recent one, it certainly wasn't as bad, but it was constant. The cream still fixed it.
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Re: My 6 keys to beating anal fissures

Postby missy moo » 30 May 2017, 01:35

Hey just realised your in auzzie I'm in nz I haven't seen anyone on here living so close everyone is all over the place an far away. So you have a long term fissure then had a fissurectomy an botox then with a small new fissure it healed with cream. Here in nz they don't offer lis till after trying everything else Did your first fissure have a skin tag? Was it removed? And did a specialist do it for you? Here it costs $3000-$10,000 to have a fissure sorted privately so I'll be going through the public health service.
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Re: My 6 keys to beating anal fissures

Postby intrepidpanther » 16 Jul 2017, 10:08

Thanks for sharing your tips, what ratio of psyllium husks to water have you been using?
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